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General NPI Number Information
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NPI Number | 1003128844
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Entity Type | Individual
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Provider Name | JOY R BOGART
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Gender | Female
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Dates
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Enumeration Date | 07/09/2010
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 2900 MEDICAL CENTER PKWY STE 310
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City | BENTONVILLE
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State | AR
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Zip | 72712-3214
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Country | US
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Telephone | 479-553-4540
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Fax |
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Provider Business Mailing Address
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Address Line | 1 CHILDRENS WAY SLOT 900
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City | LITTLE ROCK
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State | AR
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Zip | 72202-3500
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Country | US
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Telephone | 501-364-3620
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Fax | 501-364-3994
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R72169
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 230585
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License Number State | AR
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